Patient care patient care areascapacities processes

• Patient care:
✓ Patient care areas/capacities: processes to maximize
the use of regular patient care capacity (such as empty-
ing the emergency department of admitted patients),
and establishment of alternative areas of adequate care
(such as transitioning critical patients to post-anesthesia
care units, and clinical procedures areas that can sup-
port critical care services). Accurate triage of arriving
patients to appropriate areas of care is a vital process in
accomplishing this objective. Engineered (managed)
degradation of services should be incorporated into the
patient care capacity planning. Delineating managed
degradation strategies (see Chapter 9) that maintain the
highest available level of care when capacity is exceed-
ed is important: the use of hallways for patient care,
the use of nontraditional personnel for patient care serv-
ices (for example, paramedics to provide patient moni-
toring in the hospitals), the use of medical students to
provide prolonged bag ventilation are all options to
prevent catastrophic failure of patient care services
when planned capacity is exceeded.
✓ Patient tracking: adequate method of tracking
patients through the system — internally within the
healthcare facility and reporting externally to a medical
care information node that conveys composite
information to PSAT and forwarding to MH-LIF.
✓ Patient privacy: capability to retain patient privacy
as much as possible.
✓ Lab and radiology ( see patient diagnostics).
✓ Ability to provide acute psychological interventions
once diagnosed with mental illness — preferably sepa
rate from clinical treatment areas if patient has been
cleared of physical illness or injury.
✓ Morgue services: surge capacity should be integrated
with the medical examiner’s emergency operations
plan, the Mass Fatality Function, and law enforcement
investigators.
✓ Discharge services: ability to rapidly identify
inpatients who are stable for discharge, and expedite
7 - 12
7
MaHIM: Medical and Health Operations Functional Area

Joseph A. Barbera, M.D.
Anthony G. Macintyre, M.D.
Mass Casualty Medical and Health Incident Management
The Institute for Crisis, Disaster, and Risk Management
7
MaHIM: Medical and Health Operations Functional Area
discharge procedures while maintaining patient safety and
understanding. This should be coordinated with the Post-
acute Medical Care Sub-function.
• Plant operations:
✓ Air intake: ability to close intake to buildings or
selected areas of the buildings to provide shelter - in -
place.
✓ Isolation of parts of building (e.g., smoke
compartments).
✓ Structural evaluation: supported by Logistics,
Structural Integrity Evaluation Processes.
✓ Waste disposal: capability to adequately dispose of
increased waste load from the increased patient load.